Superficial Basal cell carcinoma

From dermoscopedia

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The basaloid tumor islands in superficialThis glossary term has not yet been described. basal cell carcinomais the most common skin cancer, and one of the most common cancers in the United States.[1] While BCC has a very low metastatic risk, this tumor can cause significant disfigurement by invading surrounding tissues (sBCC) extend from the epidermis into the papillary dermis [1][2][3]. DermoscopyThe examination of [skin lesions] with a 'dermatoscope'. This traditionally consists of a magnifier (typically x10), a non-polarised light source, a transparent plate and a liquid medium between the instrument and the skin, and allows inspection of skin lesions unobstructed by skin surface reflections. Modern dermatoscopes dispense with the use of liquid medium and instead use polarised light to cancel out skin surface reflections. can predict the diagnosisis the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines with variations in the use of logic, analytics, and experience to determine "cause and effect". In systems engineering and computer science, it is typically used to determine the causes of symptoms, mitigations, and solutions of sBCC with a sensitivity of 81.9% and specificity of 81.8% [4].


The features predictive of superficial BCCAbbreviation for Basal Cell Carcinoma with odds ratios ranging between 2.7 and 7.7 include [5][6][4][7][8][9][10][11][12][13][14]:

1. Leaf-like structuresThis glossary term has not yet been described.

2. Spoke wheel-like structures

3. Concentric structures/globulesThis glossary term has not yet been described. (variant of spoke wheel like structuresThis glossary term has not yet been described.)

4. Brown dotsDots are small, round structures of less than 0.1 mm in diameter that have a red color when corresponding to blood vessels; however, when due to melanin, their color ranges from black, brown, to blue-gray depending on the depth and concentration of the melanin in the skin (Tyndall effect). – correspond to small pigmented BCC tumor islands located at the dermal-epidermal junction. Similar size pigmented BCC tumor islands in the papillary dermis appear as blue-gray dots/globules.

5. Short fine superficial telangiectasia

6. Multiple small erosions

7. Shiny white blotches and strandsWhite structures in the form of circles, oval structures, or large structureless areas that are bright-white longer and less well defined lines oriented parallel or distributed haphazardly, or forming blotches (shiny white clods). Seen only under polarized dermoscopy.. It is not uncommon for sBCC to only reveal shiny white blotches and strandsWhite structures in the form of circles, oval structures, or large structureless areas that are bright-white longer and less well defined lines oriented parallel or distributed haphazardly, or forming blotches (shiny white clods). Seen only under polarized dermoscopy. with or without short fine superficial telangiectasia.


Features predictive against the diagnosis of sBCC include [4]:

1. arborizing vesselsanalytic term is branched vessels; Bright red sharply in focus large or thick diameter vessels dividing into smaller vessels; BCC (negative odds ratio 2.1)

2. blue-gray ovoid nest/s (negative odds ratio 3.2)

3. ulceration (negative odds ratio 2.1)


Features that may be seen in sBCC but that are not predictive for or against the diagnosis of sBCC include multiple non-aggregated blue-gray globules and multiple in-focus blue-gray dots, which often present in a buckshot scatter distribution [4].


Heavily pigmented sBCC can sometimes mimic melanomaThis glossary term has not yet been described. [15]. In such lesions the leaf-like or spoke wheel-like structures can resemble streakslines radial (always at periphery) streaks Reed nevus melanoma recurrent nevus (i.e., radial streamingRadial linear extensions at the lesion edge and pseudopodsBulbous and often kinked projections seen at the lesion edge, either directly associated with a network or solid tumor border.) and the blue-gray globules can take on brown to black colorsThis glossary term has not yet been described. making it virtually impossible to differentiate these sBCC from melanoma [15][16].
  1. Tabanlıoğlu Onan et al.: Correlation between the dermatoscopic and histopathological features of pigmented basal cell carcinoma. J Eur Acad Dermatol Venereol 2010;24:1317-25. PMID: 20337825. DOI.
  2. Stephens et al.: Spoke wheel-like structures in superficial basal cell carcinoma: a correlation between dermoscopy, histopathology, and reflective confocal microscopy. J. Am. Acad. Dermatol. 2013;69:e219-21. PMID: 24124839. DOI.
  3. Hirofuji et al.: Superficial type of multiple Basal cell carcinomas: detailed comparative study of its dermoscopic and histopathological findings. J Skin Cancer 2011;2011:385465. PMID: 21151508. DOI.
  4. 4.0 4.1 4.2 4.3 Lallas et al.: Accuracy of dermoscopic criteria for discriminating superficial from other subtypes of basal cell carcinoma. J. Am. Acad. Dermatol. 2014;70:303-11. PMID: 24268311. DOI.
  5. Khokhar &: Growling, flushing, and a 30-pound weight loss. Hosp. Pract. (Off. Ed.) 1985;20:64-5. PMID: 2411744.
  6. Suppa et al.: Dermoscopic variability of basal cell carcinoma according to clinical type and anatomic location. J Eur Acad Dermatol Venereol 2015;29:1732-41. PMID: 25627865. DOI.
  7. Emiroglu et al.: The relation between dermoscopy and histopathology of basal cell carcinoma. An Bras Dermatol 2015;90:351-6. PMID: 26131865. DOI.
  8. Giacomel & Zalaudek: Dermoscopy of superficial basal cell carcinoma. Dermatol Surg 2005;31:1710-3. PMID: 16336893.
  9. Popadić &: Dermoscopic features in different morphologic types of basal cell carcinoma. Dermatol Surg 2014;40:725-32. PMID: 25111343. DOI.
  10. Trigoni et al.: Dermoscopic features in the diagnosis of different types of basal cell carcinoma: a prospective analysis. Hippokratia 2012;16:29-34. PMID: 23930054.
  11. Pan et al.: Dermatoscopy aids in the diagnosis of the solitary red scaly patch or plaque-features distinguishing superficial basal cell carcinoma, intraepidermal carcinoma, and psoriasis. J. Am. Acad. Dermatol. 2008;59:268-74. PMID: 18550207. DOI.
  12. Ahnlide et al.: Preoperative prediction of histopathological outcome in basal cell carcinoma: flat surface and multiple small erosions predict superficial basal cell carcinoma in lighter skin types. Br. J. Dermatol. 2016;175:751-61. PMID: 26921200. DOI.
  13. Micantonio et al.: Vascular patterns in basal cell carcinoma. J Eur Acad Dermatol Venereol 2011;25:358-61. PMID: 20561131. DOI.
  14. Puig et al.: Dermoscopic criteria and basal cell carcinoma. G Ital Dermatol Venereol 2012;147:135-40. PMID: 22481576.
  15. 15.0 15.1 Altamura et al.: Dermatoscopy of basal cell carcinoma: morphologic variability of global and local features and accuracy of diagnosis. J. Am. Acad. Dermatol. 2010;62:67-75. PMID: 19828209. DOI.
  16. Bakos et al.: Radial streaking: unusual dermoscopic pattern in pigmented superficial basal cell carcinoma. J Eur Acad Dermatol Venereol 2007;21:1263-5. PMID: 17894724. DOI.